Rapid HIV treatment starts rose sharply in Wuhan over a decade but remain suboptimal

The share of people living with HIV in Wuhan, China, who began combination antiretroviral therapy within seven days of diagnosis rose from 2.35 percent in 2016 to 52.87 percent in 2025, according to a retrospective cross-sectional study published in AIDS Research and Therapy. Despite that tenfold increase, the researchers describe the overall rate of rapid initiation as still suboptimal.

The study drew on records for 7,389 HIV/AIDS patients reported between 2016 and 2025 in Wuhan, Hubei province, using data collected from China’s National Disease Prevention and Control Information System. Following WHO guidelines, the authors defined rapid initiation of combination antiretroviral therapy, or cART, as starting treatment within seven days of HIV confirmation.

Across the whole decade, the median time from confirmation to the start of cART was 21 days, with an interquartile range of 11 to 41 days. That means half of the patients in the dataset began treatment within three weeks of diagnosis, a figure that reflects both the early years of the study period, when rapid starts were rare, and the marked acceleration seen in recent years.

A chi-square test for trend confirmed that the proportion of patients receiving rapid cART rose significantly over the calendar years, with a P value for trend below 0.001. The upward trajectory was also visible in the multivariable model: compared with the reference period, patients diagnosed in 2019 to 2022 had significantly higher odds of rapid initiation (OR = 4.600, 95% CI: 3.635–5.823), and those diagnosed in 2023 to 2025 had the highest odds of all (OR = 14.968, 95% CI: 11.813–18.965).

Beyond calendar year, several patient characteristics were associated with faster treatment starts. Patients aged 50 years and above had higher odds of rapid initiation than younger adults (OR = 1.302, 95% CI: 1.064–1.593), as did people identified through medical institutions rather than other detection routes (OR = 1.194, 95% CI: 1.020–1.397). Late diagnosis was also linked to higher odds of starting treatment within seven days (OR = 1.362, 95% CI: 1.162–1.597).

Other groups faced slower starts. Unmarried individuals had lower odds of rapid cART initiation (OR = 0.751, 95% CI: 0.612–0.921), as did people who were divorced or widowed (OR = 0.773, 95% CI: 0.614–0.972). Patients with inter-city mobility — those whose circumstances involved movement between cities — also had reduced odds (OR = 0.703, 95% CI: 0.611–0.810), a pattern the authors link to the challenges that migrant patients can face in staying connected to local treatment services.

The authors conclude that the proportion of rapid cART initiation in Wuhan increased from 2016 to 2025 but remained suboptimal, and that the factors significantly associated with rapid initiation included calendar year, age at diagnosis, marital status, migration status, detection source, and late diagnosis. They suggest that targeted interventions for younger, unmarried, divorced or widowed, and migrant patients, along with improved referral systems and enhanced drug accessibility, may further increase the rapid initiation rate.

Rapid initiation of combination antiretroviral therapy plays a critical role in reducing mortality and improving quality of life among people living with HIV/AIDS, the study notes, which is why the WHO-endorsed seven-day benchmark matters for treatment programmes. The findings offer a scientific basis for developing targeted interventions, according to the research team, which included Han Yan, Xuejiao Hu, Xiaoning Li, Rong Hu, Cong Liu, Hongfei Ma and Xiaobing Yang.

As a retrospective cross-sectional analysis of surveillance records from a single Chinese city, the study describes associations rather than causal effects, and its findings reflect the reported population in Wuhan over 2016 to 2025. The authors state that the analysis was designed to characterise the factors associated with rapid cART initiation and to inform the development of targeted interventions in that setting.

Subject of Research: Factors associated with rapid initiation of antiretroviral therapy among people living with HIV in Wuhan, China

Article Title: Factors associated with rapid initiation of combination antiretroviral therapy among people living with HIV from 2016 to 2025 in Wuhan, Hubei, China: a decade-long retrospective cross-sectional study

Article References: Yan, H., Hu, X., Li, X., Hu, R., Liu, C., Ma, H., & Yang, X. (2026). Factors associated with rapid initiation of combination antiretroviral therapy among people living with HIV from 2016 to 2025 in Wuhan, Hubei, China: a decade-long retrospective cross-sectional study. AIDS Research and Therapy. https://doi.org/10.1186/s12981-026-00971-5

Image Credits: AI Generated

DOI: 10.1186/s12981-026-00971-5

Keywords: HIV, antiretroviral therapy, rapid initiation, Wuhan, China, retrospective cross-sectional study, late diagnosis, migration, WHO guidelines, treatment cascade, Factors, associated